Then and Now in Epidemiology

Reflection Question: W.E.B. Du Bois is considered the father of social epidemiology. He conducted the first sociological case study of a Black community in the United States. He used empiricism, a belief in prioritizing experience and observation in knowledge-building, to link structural racism to poor health and high mortality among Black residents in the 7th Ward of Philadelphia. View the Who was W.E.B. Du Bois?Links to an external site. video (2:44 minutes) and then reflect on the following question together. Imagine W.E.B. Du Bois got in a time machine and traveled to today’s Philadelphia. Do you think he would be surprised to see city neighborhoods having health outcomes that are uncannily still derived by race, employment status, and neighborhood segregation level as they were in his native 19th Century Philadelphia? How so? What do you think he would say to today’s public health professionals? Application Question: In the reflection question, we talked about what W.E.B. Du Bois would say if he time-traveled forward to today’s Philadelphia. Let’s take this a step further now that we’re going through the assigned course materials. Would he be surprised to see professionals using the same systematic quantitative analysis to characterize health and social outcomes grouped by race, employment status, and neighborhood segregation level as was used in 19th Century Philadelphia? Would he expect to observe similar variations in race, employment status, and neighborhood segregation level, or would he expect to see something different? How so? Prevention is a significant component of epidemiology and requires actions aimed at minimizing (and when possible eliminating) the impact of disease and disability. Prevention may entail interventions that reduce the risk of disease or certain levels of threats to health. The further “upstream” the prevention is located, the more people the intervention can help, but also the more difficult it is to detect the effect. After all, chronic disease processes require years before the person knows even of the disease's existence. In order to help understand the impact of upstream determinants, let us take this example based on a real situation. Let’s say now W.E.B. Du Bois is turning his attention to city water systems. In the summer, he learns that children are developing neurological problems after drinking the water due to chemical irritants like lead and mercury in the river. He learns that a factory located literally “upstream” is dumping waste that contains lead and arsenic. He decides to take action by talking to the CEO of the factory.Metaphorically speaking, this is an example of primary prevention. Let’s imagine that he is speaking with us all in this course about this situation. What would you want him to say to the CEO? Who are the stakeholders in this situation? Think beyond even the children. Let’s further assume that he asks your thoughts on doing a needs assessment for prevention (primordial, primary, secondary, or tertiary). Which one would you focus on and what would you tell him?